Floret D
Service d'urgence et de réanimation pédiatrique, hôpital Edouard-Herriot, Lyon, France.
Arch Pediatr. 1997 Nov;4(11):1119-24. doi: 10.1016/s0929-693x(97)88982-8.
Influenza is the best known model of bacterial-viral co-infection. Epidemics of influenza result in an increased hospital admission rate for bacterial pneumonia due to pneumococcus, Haemophilus influenzae and Staphylococcus aureus. Similarly, an increased incidence of meningococcal diseases, particularly severe forms, follows the influenza outbreaks, with a two week delay. Though the precise mechanism is not known, the depression of host's phagocytes bactericidal activity by the influenza virus seems to be involved. An increased incidence of invasive group A beta hemolytic streptococcal infections, particularly necrotizing fasciitis and toxic shock syndrome, is also observed in relation with chickenpox. The reason for this association is unclear and appears not to be limited to the disruption of the cutaneous barrier which leads to the cutaneous infections in this disease. Bacterial-viral co-infection is not a justification for a systematic antibiotic prescription in viral diseases. Severe bacterial disease will be best prevented through viral immunization, thus encouraging the development of viral vaccines and immunization campaigns.
流感是最为人熟知的细菌 - 病毒合并感染模型。流感流行会导致因肺炎球菌、流感嗜血杆菌和金黄色葡萄球菌引起的细菌性肺炎住院率上升。同样,流感爆发后,脑膜炎球菌疾病的发病率会增加,尤其是严重形式的疾病,会有两周的延迟。尽管确切机制尚不清楚,但流感病毒对宿主吞噬细胞杀菌活性的抑制似乎与之有关。与水痘相关的侵袭性A组β溶血性链球菌感染的发病率也有所增加,尤其是坏死性筋膜炎和中毒性休克综合征。这种关联的原因尚不清楚,似乎并不局限于导致该疾病皮肤感染的皮肤屏障破坏。细菌 - 病毒合并感染并非在病毒性疾病中系统性使用抗生素的理由。通过病毒免疫接种能最好地预防严重细菌疾病,因此鼓励开发病毒疫苗和开展免疫接种运动。